Impact of delayed effects on human old-age mortality 1

Demogr Res. Jan-Jun 2019;40:1167-1210. doi: 10.4054/DemRes.2019.40.41. Epub 2019 May 10.

Abstract

Background: There is growing empirical evidence supporting theories of developmental origins of health and disease (DOHaD). However, the implications of DOHaD conjectures for aggregate population patterns of human disease, disability, mortality and aging are poorly understood.

Objective: We empirically test two predictions derived from a formal model of aggregate population-level impacts of DOHaD. This model predicts that populations potentially influenced by delayed effects should experience singularities in their adult mortality patterns that can be empirically detected from aggregate data.

Methods: We test predictions using a large mortality database for populations in the Latin American and Caribbean region (LAC) spanning nearly one hundred years of mortality history.

Results: Results are consistent. within explicit bounds of uncertainty, with expected patterns. We find that younger cohorts in countries whose mortality decline starts more recently experience deceleration in survival gains at older ages, attenuation of the rate of aging at older ages and a decline in the association between early childhood and adult mortality.

Conclusions: Results point to the importance of adverse early conditions for human longevity. Future research should shed light on the impact on morbidity, disability and healthy life expectancy.

Contribution: To our knowledge this is the first time that implications of DOHaD conjectures for populations' mortality patterns are formulated precisely and empirically tested with aggregate population data.

Keywords: DOHaD; delayed effects; older age mortality patterns; senescence.